NPI | 1144693565 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015036182) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 77043) |
Enumeration Date | 2015-11-06 |
Last Update Date | 2015-12-01 |